Provider Demographics
NPI:1942907712
Name:STANFIELD, GINGER
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:STANFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5709
Mailing Address - Country:US
Mailing Address - Phone:575-791-8817
Mailing Address - Fax:
Practice Address - Street 1:316 KELLY ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5709
Practice Address - Country:US
Practice Address - Phone:575-791-8817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty